Humoral Response to Pfizer BNT162b2 Vaccine Booster in Maintenance Hemodialysis Patients

Moshe Shashar, Naomi Nacasch, Ayelet Grupper, Sydney Benchetrit, Tamar Halperin, Daniel Erez, Ilan Rozenberg, Pnina Shitrit, Yaron Sela, Ori Wand, Keren Cohen-Hagai

Research output: Contribution to journalArticlepeer-review


Introduction: Coronavirus disease is associated with increased morbidity and mortality in maintenance hemodialysis (MHD) patients. Recent breakthrough infection in vaccinated people has led some authorities to recommend a booster dose for patients fully vaccinated 5-8 months ago. We aimed to assess the humoral response of MHD patients following a booster dose with the BNT162b2 vaccine. Methods: The study included 102 MHD patients vaccinated with 2 doses of the BNT162b2 (Pfizer-BioNTech) vaccine. A third dose (booster) was recommended to all MHD patients in our center and was given to those who opted to receive it, resulting in a booster group and a control group that did not receive the booster. Previous exposure was excluded by testing for the presence of the anti-nucleocapsid antibody (SARS-CoV-2) or positive PCR. We assessed the humoral response before and after the booster dose. Results: Of 66 patients in the booster group, 65 patients (98.5%) developed a positive antibody response, from 472.7 ± 749.5 to 16,336.8 ± 15,397.3, as compared to a sustained decrease in the control group (695.7 ± 642.7 to 383.6 ± 298.6), p < 0.0001. No significant adverse effects were reported. Prior antibody titers were positively correlated to IgG levels following the booster dose. There was a significant association between malnutrition-inflammation markers and the humoral response. Conclusions: Almost all MHD patients developed a substantial humoral response following the booster dose, which was significantly higher than levels reported for MHD patients following administration of 2 doses alone. Further studies and observations are needed to determine the exact timing and dosing schedule.

Original languageEnglish
Pages (from-to)207-214
Number of pages8
JournalAmerican Journal of Nephrology
Issue number2-3
StatePublished - 1 Apr 2022


  • COVID-19 vaccine
  • COVID-19 virus
  • Hemodialysis


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